Postexercise Glycemic Control in Type 1 Diabetes Is Associated With Residual β-Cell Function.

Area of Science:

• Endocrinology
• Metabolic Diseases
• Exercise Physiology

Background:

• Type 1 diabetes (T1D) management requires understanding factors influencing glycemic responses to exercise.
• Continuous glucose monitoring (CGM) provides insights into glycemic fluctuations.
• Residual beta-cell function, measured by C-peptide, varies among individuals with T1D.

Purpose of the Study:

• To investigate how residual beta-cell function affects continuous glucose monitoring (CGM) outcomes after acute exercise in individuals with T1D.
• To determine if C-peptide levels can predict glycemic responses to exercise in T1D.

Main Methods:

• Thirty participants with T1D underwent a 7-day CGM monitoring period.
• A mixed-meal test assessed C-peptide and glucagon levels to categorize participants into undetectable, low, or high C-peptide groups.
• Participants completed a 45-minute treadmill exercise session, followed by 48-hour CGM monitoring.

Main Results:

• The high C-peptide group (Cpep_high) showed significantly more time in the target glucose range (3.9-10 mmol/L) post-exercise compared to low (Cpep_low) and undetectable (Cpep_und) groups.
• Hyperglycemia and glycemic variability were significantly lower in the Cpep_high group.
• While Cpep_und and Cpep_low groups experienced worsening glucose control post-exercise, the Cpep_high group showed improvement.

Conclusions:

• Residual beta-cell function is a significant factor in the inter-individual variability of acute exercise's glycemic benefits in T1D.
• Quantifying C-peptide levels can help tailor exercise recommendations and support for individuals with T1D.
• Personalized glycemic management strategies incorporating residual beta-cell function may optimize exercise outcomes in T1D.